Secondary open-angle glaucoma and central retinal vein occlusion in a patient with primary pulmonary hypertension

A 22-year-old man with primary pulmonary hypertension presented with dilated episcleral veins and increased intraocular pressures. His increased intraocular pressure was resistant to therapy with topical and systemic anti-glaucoma medications. He developed serous macular detachment in one eye that resolved spontaneously. He later presented with central retinal vein occlusion in the same eye, which responded to intravitreal bevacizumab. Ocular manifestations of primary pulmonary hypertension develop as a result of reduced venous outflow due to increased venous pressures. Management of ocular complications in patients with systemic disease resulting in short life expectancy remains a challenge.